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Unlucky 13: Matt Moore latest to face Tommy John surgery

If Matt Moore does get his ulnar collateral ligament replaced, the hard-throwing left-hander would be the 13th pitcher on a major league roster to require the procedure since the beginning of spring training, an alarming incidence.

Unlucky 13: Matt Moore latest to face Tommy John surgery

As the Tampa Bay Rays brace for the possibility of losing top-flight starter Matt Moore for the season due to ligament damage that will likely require Tommy John elbow surgery, baseball is again reminded of the devastating effect of these injuries.

Already this spring, there have been way too many reminders for anyone's liking.

Moore, who went 17-4 with a 3.29 ERA last season, was examined by noted orthopedist James Andrews on Wednesday and, although the results have not been revealed, Rays manager Joe Maddon said it's "not a slam-dunk surgery right now.''

If he does get his ulnar collateral ligament replaced, the hard-throwing left-hander would be the 13th pitcher on a major league roster to require the procedure since the beginning of spring training, an alarming incidence.

The Atlanta Braves were hit twice last month when they lost Kris Medlen and Brandon Beachy to torn elbow ligaments, wiping out two-fifths of their rotation. This week, Braves reliever Cory Gearrin confirmed he will need the operation as well.

One of them was All-Star Game starter Matt Harvey of the New York Mets, who also lost closer Bobby Parnell to a blown elbow ligament after one outing this season.

"You can invest on pitchers and everything looks great on paper, and the next thing you know, boom, they're all down,'' Mets general manager Sandy Alderson said before learning of Parnell's fate. "And it's hard to predict, whether it is a starting pitcher coming back from injury, (or) relief pitchers who have never been hurt.''

Alderson would like to see further research done into the causes of UCL injuries, and indeed one such study is taking place with Major League Baseball's approval under the supervision of Stan Conte, vice president of medical services for the Los Angeles Dodgers.

The study began last year by surveying all the major and minor-leaguers to examine their history of injuries and the prevalence of players – mostly pitchers – who had undergone the Tommy John procedure.

Conte said from 2002-11 the average number of these surgeries among major leaguers fell just short of 16, then the figure skyrocketed to a record 36 in 2012 before dropping down to 19 in 2013.

"Of course, this year we're definitely ahead of schedule when it comes to the amount,'' Conte said. "When you look at Tommy Johns from 2003-2013, most of them occurred in June, not in April and May. This has definitely been one of the strongest starts, for whatever reason.''

An explanation indeed remains elusive, although there's some belief that the operation's high success rate has led to a more aggressive approach in treating elbow-ligament tears, instead of going with the conservative rest-and-rehab strategy.

The rash of Tommy John surgeries has been disconcerting for the people who spend so much time and effort trying to prevent them. One of them is Glenn Fleisig, research director for the American Sports Medicine Institute in Birmingham, Ala., who is working with Conte on the study and is an expert on the biomechanics of pitching.

Fleisig has examined UCL injuries for more than a decade and, like his collaborators, expected their numbers to decrease with better knowledge of their causes and of proper mechanics. That hasn't been the case.

Sports medicine, Fleisig noted, aims to help athletes perform at their best while also avoiding injuries. Sometimes those goals work in unison, sometimes they conflict.

"What's happened over the past decade or so is, through science and medicine (plus training and nutrition), we've enabled more pitchers to maximize their potential,'' Fleisig said. "If you look at any team's major and minor league rosters, they have more guys bringing it at 95 mph than 10 years ago or 20 years ago. But that has come at the cost of the ligaments and tendons.

"As we've optimized your ability to have strong muscles and the ability to use the muscles at the right time with proper mechanics, the ligaments and tendons have not been improved as much as the muscles.''

That's because ligaments and tendons don't get as healthy a supply of blood as the muscles, a physiological fact no amount of training or tender care will alter.

That reality has led some clubs to stockpiling arms as the best safeguard against the likelihood some pitchers will break down.

The Washington Nationals, for example, had such a surplus of starting candidates during spring training, they could afford to let go of veteran Chris Young – picked up by the Seattle Mariners – and move Ross Detwiler to the bullpen.

Then again, three members of the Washington rotation – Stephen Strasburg, Jordan Zimmermann and Taylor Jordan – have had Tommy John surgery.

"The fact of the matter is, this is an unnatural act every time they throw the baseball, so you worry about it. Everybody worries about it,'' manager Matt Williams said. "They go out there and compete on a regular basis, throw that ball 100 times in a game. There's wear and tear.''